Reimbursement Specialist

Department

Revenue Cycle
Job Summary

Provides administrative support responsible for accurate and timely posting of Surgery, Emergency Room (ECC) charges for either SMH or North Port, hospital wide observation charges, or Delivery/High Risk Antepartum/Testing/Triage charges, under the direction and supervision of the Revenue Cycle Management. Provides compliant charging practices for all payors by reviewing the medical record for appropriate clinical documentation that supports the accuracy of charges. Assists in the review and resolution of Surgery, Emergency Room, Observation, or Delivery/ High Risk Antepartum/Testing/Triage charge Correct Coding Initiative (CCI) edits. Acts as a mentor and trainer to other Reimbursement Specialists.

Required Qualifications

- Require a minimum of two (2) years of health care experience involving charging practices and patient flow processes. Current coding certification will substitute for the required experience.

Preferred Qualifications

- Prefer coding certification.
- Prefer clinical certification from a recognized health care credentialing organization in a specialty area (i.e., RRA, RT, VI, CI, RCIS, RVS, CSFA, and CST).
- Prefer demonstrated interpersonal and communication skills.
- Require a working knowledge of commonly used computer applications.
- Prefer the ability to work with minimal supervision.
- Prefer demonstrated proficiency with medical terminology.
- Prefer demonstrated proficiency with specific charging and coding as it applies to various departments (i.e. Surgery, Emergency Room, Observation, or Delivery/High Risk Antepartum/Testing/Triage.

Mandatory Education

HS EQ: High School Diploma, GED or Certificate

Additional Details

Four to five days a week.

Employment Screening Requirements

As part of Sarasota Memorial Health Care System’s commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/

- Prefer coding certification.
- Prefer clinical certification from a recognized health care credentialing organization in a specialty area (i.e., RRA, RT, VI, CI, RCIS, RVS, CSFA, and CST).
- Prefer demonstrated interpersonal and communication skills.
- Require a working knowledge of commonly used computer applications.
- Prefer the ability to work with minimal supervision.
- Prefer demonstrated proficiency with medical terminology.
- Prefer demonstrated proficiency with specific charging and coding as it applies to various departments (i.e. Surgery, Emergency Room, Observation, or Delivery/High Risk Antepartum/Testing/Triage.

- Require a minimum of two (2) years of health care experience involving charging practices and patient flow processes. Current coding certification will substitute for the required experience.